Banding, Reflux, Testing....RNY

Recently I went and had my upper GI test done. They found a hiatal hernia and reflux (although I am symptom free). I have been trying to decide on wether I want to go with the banding or the RNY based on many factors - the amount of weight I need to loose, malnutrition, vitamins, surgery, recovery - just to name a few. The doctors office called to tell me the results of the upper GI and that I would need another test done (some kind of scopy) to determine if I can have the banding. I understand the need for testing prior to surgery, but, when questions are asked and they can't be answered on the phone regarding what the test is all about, how it is done, is this test something I need to have if I decide to have the RNY and I get talked around a tree I get a little upset. I asked if I needed to make an appointment with Dr. Aranow to get my questions answered and I was told an appointment could be made but he wouldn't see me until after my test. But why have the test if I have not decided yet - I asked her. I asked her if I needed the test if I decided on the RNY - she didn't know. Yes, I am interested in the banding...but...I have not made up my mind yet and I think that I deserve the right to talk to the doctor about any concerns I have regarding testing (pre and post) and the trouble I am having deciding which surgery is best for me as well as talking about any potential bumps in the road. So I get more upset with this woman on the phone and have my words twisted who tels me 'deciding not to have the extra test because I might not need it for the RNY when I wanted the banding was not right' and the Dr. won't allow me to make descisions based on things like that (or something to that affect). Then she wanted to know my reasons for not being able to decide - AS IF I WERE LIEING!! Now I'm waiting to see what Dr. Aranow says about this extra test and the RNY. I'm not sure who I spoke to on the phone, but I will tell you this....I think I had a run in with her at the office the other day too...I have read rave reviews about Dr. Aranow's staff but I'm questioning this person.

First, no surgeon's office is perfect and many people have experienced a slight misunderstanding or even personality clash on the way to a very successful long-term relationship with that surgeon's staff. In any decision there is lots of compromise-- your surgeon is well-regarded and gets rave reviews on this site so perhaps your negative experience is just a minor bump in the road. Secondly, given the competition among highly skilled bariatric surgeons in this state, there is no reason why anyone needs to stay with a program in which she (or he) does not feel 100% supported. Now, count this as a shameless plug for Norwalk Hospital where all four surgeons who perform bariatric surgery are committed to performing it laparoscopically and where patient attention is of paramount importance. Not that any doctor's office is perfect, but I just find it incredibly difficult to understand why people endure long waits for their initial appointments and even longer waits for their surgeries, when equally skilled surgeons are available who would perform the procedure laparoscopcially in a much shorter timeframe. I know that we all choose surgeons with whom we feel the best rapport and that the overwhelming majority of bariatric surgeons in CT are skilled and compassionate. But, sometimes I think many of us fall victim to thinking that there is only one surgeon for us and that we must jump through whatever hoops are put before us (whether waiting several months for an initial appointment, needing to lose mandatory pre-surgery weight or the like). However, in reality, we are highly educated consumers eager to make a life-changing decision who deserve to have the highest degree of confidence that the program we choose will be there to support us long term. You may very well have found the right program for you-- your fellow patients on this site would certainly corroberate that belief-- however, that doesn't mean that you are not entitled to prompt answers to your questions when asked and that you should be expected to be 100 % committed to bariatric surgery after an initial consultation. Good luck.

As I see it, this is a particularly difficult process to endure, not matter which doctor you choose, because this is, for most of us, the very FIRST time we are choosing to have a proceedure that is elective and having to advocte for our own helath care. Usually, we go to the doctor, tell him what's wrong and put it on cruise control while they 'fix it'. This process couldn't be any more different. Indeed, it is possible that the results of your last test make the next test absolutely necessary to see what type of candidate you are for the different types of surgery. The simple solution is NOT to ask office saff to answer questions. Ask the doctor. He reviewed your file, found that he wanted another test, and -as is standard- asked his office administrative help to call you and tell you to schedule the test. Pretty much end of story. BUT- you have questions (as is your right, of course) So, the thing to do is say- OK- Please shcedule 10 minutes of his time on a phone call with me BEFORE I have this test. I have several questions for him. That's it. Get it from the horses' mouth. I assume you choose this doctor because you felt most comfortable with him and his experience and expertise and that you trust his judgement. If so, then you're on the right path. The process is long and arduous with all the testing, so hang in there and advocate for yourself, by speaking directly with Dr. A. Best wishes, Lisa C P.S. on an OT note, I disagree that the vast majority of Dr's in the state are as qualified as Dr. Aranow. But, I'm a little 'old-school' in my qualifications. We all could get into a tit-for-tat type discussion about this, I'm sure. But, I'm going to let it go at- opinions vary about the skill and mannerisims or 'bedside manner' of different doctors. Wait time and laprosocpy were NOT a major deciding factor for me. It was everything ELSE that I found lacking in the doctors that I had to choose from. I won't go on and on...To each his own.

Oh- and a P.P.S.- this is NOT saying that Norwalk or anyone in particular, I find lacking in ANY way. In fact, they weren't really around as predominantly, as they are now, when I had my surgery three years ago-so I did not evaluate them as a option. So I only know the wonderful things that Steve and others have to say about them. Just don't want anyone to think I was directing the comments at Steve's opinion of the group out of Norwalk, which I'm sure is great.

As always, Lisa provided important insight to consider; given the thoughtfulness of her comments, it would be difficult to constue them as a slight of any sort. And, I do agree that we all have different ideas of qualification-- I have a definite bias toward laparoscopic surgery, and an unmitigated deification of my surgeon (Ralph Crum) who was able to perform my RNY laparoscopically despite my BMI being over 61 (and who has undertaken to perform other higher-risk RNY's laparoscopically). For me, given my co-morbidities, I knew that I needed a trained trauma surgeon standing over me who would be committed to performing the procedure laparoscopically. But, the important point that we would all agree upon is finding a qualified surgeon (who has performed well over 100 of the procedures you've chosen) with whom you feel you would be able to work closely for the long-term.